Tips for becoming a solid CC nursing candidate...

I would love some feedback regarding skills that are high on the priority list for a student candidate looking to work in a critical care unit. Work as a student PCT. Check. Get into a step down unit for beginner basics and getting my feet wet. Check. ACLS certification, with other complementary certifications. Check. Affiliations with organizations for networking, learning opportunities, etc. Check. Please don't be shy; I am interested in details. For instance, what would you have preferred a heads-up on beforehand, when YOU were a candidate? What is most frustrating to you about fresh meat in the unit? What do you appreciate about new grads?

I occasionally participate in panel interviews of candidates for our ICU.

You will need to be able to explain WHY you want critical care - what draws you to it. If asked your future plans, it is generally not wise to say that you want 1-2 years of CC experience as a prereq for applying to a CRNA program. That would be an instant "fail."

Experience as a PCT/extern (especially if it's in a CC unit) is very helpful. ACLS certification isn't a requirement, nor is it really much of a "plus" for a candidate. If hired, you'd be going through a bunch of added classes in any case.

Be able to express excitement, a willingness to learn, and the fact that you do not know it all. Teamwork is a biggie. You would need to be able to fit in with your coworkers, and be willing to offer help and ask for it when needed.

If you could shadow for a shift in the ICU (and were well received), that would also help your candidacy.

Dec 30, '12

Critical thinking skills, motivations, and the ability to admit you don't know it all and aren't afraid to ask for help.!

Dec 30, '12

Thanks, to you both! I was more referring to technical skills - not necessarily character development or reasons why I want to be in there. Rather, skills that would encompass a solid knowledge base once I start, so that I am immediately able to contribute to the success of my team and my patients. Any feedback of this nature would be wonderful - as I'm fairly certain that I don't, in fact, know it all... The last thing I want to do is trip over my own two feet trying to get my bearings if it doesn't need to be that way. I'd rather approach it as if I'm preparing for the job, and not so much preparing for the interview.

Dec 31, '12

I've worked in ICU for more than a decade, am a preceptor to new grads, and always participate in new grad interviews for our unit. I can tell you that sitting through a dozen interviews a day, it is most important to PRACTICE your interview skills and to sell yourself! Do not bore me or you will fail! You need to be enthusiastic about wanting to work for our hospital and specifically our unit. Its great to have long term goals but don't tell me we're a stepping stone to your CRNA in 1 year because I don't want to waste time to train someone who will leave that soon! It's great that you worked as a tech but can you tell me about your teamwork skills? I know you want "technical" skills, but honestly you should just have some common sense when I ask you scenario questions. We send you to classes and will teach you the rest on orientation. Good Luck!

Dec 31, '12

You know, I guess I'm just hoping that I can bank on the idea that I'm not wasting years of time and effort for someone to tell me that everything I'm doing this for is null if I don't pass a personality test. I have such a wonderful rapport with all of my colleagues, and I have for many MANY years. So, forgive me if I find it incredibly amusing that even though I've clarified my expectations, I can't get a more straightforward idea of what it is I could be doing * other than character development * to be more available for my future colleagues to utilize. Is there no one out there who can communicate explicitly about my inquiry?????

You know, I guess I'm just hoping that I can bank on the idea that I'm not wasting years of time and effort for someone to tell me that everything I'm doing this for is null if I don't pass a personality test. I have such a wonderful rapport with all of my colleagues, and I have for many MANY years. So, forgive me if I find it incredibly amusing that even though I've clarified my expectations, I can't get a more straightforward idea of what it is I could be doing * other than character development * to be more available for my future colleagues to utilize. Is there no one out there who can communicate explicitly about my inquiry?????

I have a question...are you looking to be a tech in a critical care unit, or a critical care nurse??? I read your question, their responses-which, IMO, are pretty good...If you are planning to be a critical care nurse as a new grad, you will build on your experiences, but the information that some of the posters, are pretty sound to me. I am a new grad and start in a CC position in Feb, and for the poster that sits on a panel that interviews nurses, they may be impressed by your ability to be comfortable with the atmosphere, but do want to know those aspects about you as well...I just need clarification of what actual position you are desiring...maybe I'm not connecting with what you are saying-post holiday brain I guess!

Dec 31, '12

I'd love to be working eventually in CICU. I have a friend who works in ICU, who advised me to be very comfortable with cardiac monitoring, hemodynamics, and all types of shock, but I was just aiming to build on that. Am I expecting too much? I mean, in reality, will I not be expected to do any more than these things and shoot off sharp one-liners? I do have a tendency to get ahead of myself sometimes, just appreciate directness, I guess.

I'd love to be working eventually in CICU. I have a friend who works in ICU, who advised me to be very comfortable with cardiac monitoring, hemodynamics, and all types of shock, but I was just aiming to build on that. Am I expecting too much? I mean, in reality, will I not be expected to do any more than these things and shoot off sharp one-liners? I do have a tendency to get ahead of myself sometimes, just appreciate directness, I guess.

Whatever path you choose, if you start out in your first CC position or transition to CC, you will be in class. They do not expect you to come on the floor and identify a couplet, ST elevations, depressions, etc. without a review and proof of competency.If you want familiarity with those subjects, there are critical care books-The one I have from nursing school is Critical Nursing Secrets...there may be others, but they have hemodynamic monitoring, cardiac monitoring, system by system monitoring, assessments, etc. A great reference book for school and for the floor. You can take a cardiac monitoring course if you choose. A poster also said to shadow an ICU nurse, which I think is the best route. Find that if you are able to do that as well, especially if you can in the unit that you want to be in, you may make an impression on that unit...hope this helps!!!

Dec 31, '12

Wow, that's great to know! Thank you for your thoughtful response. I will look for the book. I've read about other CC books on the market, and other posters are raving about those, too. . . . so, it looks like I'll be looking for those with the best reviews. Again, thanks for seeing past my temporary petulance! My appreciations!!!

Dec 31, '12

If you work as a tech in the area of your interest (ICU, et al), your coworkers and manager will have already decided based on your personality and work ethics whether or not they want to hire you on as a new grad nurse. The interview would only be a formality. I've sat through interviews that bombed but we hired them anyways because we knew they were an awesome coworker as a tech and vice versa. However, if you don't have an "in" like that, all the interviewee has is maybe 20 minutes to sell themselves to us. All we have to go on is what you say and how you present yourself in that brief period of time. We see a lot if resumes and portfolios. Extra curricular stuff is great too, but it comes down to #...meaning something like this... 3 new grad spots open...25 interviews...500 applicants for those positions that hr weeded through. It's a tough job market now so you should also talk to recent grads to see their experiences with the job market.

You know, I guess I'm just hoping that I can bank on the idea that I'm not wasting years of time and effort for someone to tell me that everything I'm doing this for is null if I don't pass a personality test. I have such a wonderful rapport with all of my colleagues, and I have for many MANY years. So, forgive me if I find it incredibly amusing that even though I've clarified my expectations, I can't get a more straightforward idea of what it is I could be doing * other than character development * to be more available for my future colleagues to utilize. Is there no one out there who can communicate explicitly about my inquiry?????

Sorry if I'm only amusing you, rather than giving you the answer you had hoped for. Please take my answer as a response hoping to provide some input as to what you are expected to show when you're sitting in front of the interview panel for a slot in your ICU.

You had written "I'd rather approach it as if I'm preparing for the job, and not so much preparing for the interview..." and "...technical skills - not necessarily character development ... skills that would encompass a solid knowledge base once I start, so that I am immediately able to contribute to the success of my team and my patients."

Sorry if this comes across as somewhat blunt, but are likely putting the cart before the horse.

As a new grad coming into the ICU, I have almost no expectations about the "technical skills" you bring to the table, other than:
- be able to thoroughly assess your pt
- be familiar with basic drugs, consider effects/side effects/contraindications

Other than these 2 things, I think that new folks coming into the ICU are not expected to be fully up to speed on hemodynamic monitoring, vasoactive drip titration, assisting with bedside invasive line placement, running dialysis/CRRT, managing pts on balloon pumps/IABP.

To be blunt - everything you had hoped for IS NULL if you don't pass a personality test (the job interview). We've had plenty of highly intelligent people either interview for our unit or get into the Fellowship only to crash & burn after the fact. Intelligence and motivation themselves are useless if you:
- don't LISTEN during report
- don't pay attention to what your preceptor is telling you
- ignore monitor alarms
- don't ask questions
- don't listen/observe/examine your pt & watch for changes in their condition
- focus solely on neato-keen technical skills & procedures, while ignoring the "big picture" of your pt dying in front of you
- are sloppy and not OCD about critical details of your pt & their current therapies
- are a "me me me!" type person, not a team player

During your interview, you might have a clinical question or two thrown in your direction (stuff involving DKA, DIC, HIT, sepsis, ARDS, renal failure, cardiac arrhythmias, ...). You will not be expected to know everything. You may not even be expected to know the "correct" answer to the questions. What you will be expected to do is to be honest & say "I don't know, but here's how I'd find out" rather than trying to BS your way through things.

As a person who has not worked in an ICU, you should have zero expectations about truly understanding the tasks/knowledge of an experienced ICU nurse. At this point, you might wish to skim the info available on icufaqs.org or in Paul Marino's "The ICU Book." Just try to be familiar with the stuff on an overall level, not a functional level.

Every ICU is likely different, and my perspective is that of a person who fits into my organization's ICU. I'd be surprised, though, if any ICU expected a candidate (even a nurse with years of experience outside the ICU) to be up to speed on the ins & outs of ICU equipment/procedures/technical minutiae. At best, be familiar with the basics.

Jan 2, '13

Thank you, Cruffler. I honestly do appreciate "blunt", and my frustration was mostly about the fact that I never asked about interview styles or preparation for an interview. It IS unfortunate that my personality will dictate whether or not I get the job, since I can be (not always) socially awkward to a fault. Your clarification makes much more sense to me; your summary of expectations is entirely more realistic to me than my preconceived notions of what I'm expected to know as a cc candidate, whether I'm a new nurse or not. To be sure, I AM putting the cart before the horse, but only in theory. I wanted to know what there is to know, and if there is a way to know it before I am in it. And now I know there is not a way around experience and relationships. This was really great feedback; just what I was looking for. Thank you.